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<br />JE�!RO CERTIFICATE OF LIABILITY INSURANCE OP ID z2 DATE(MMIDD/YYYY)
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />HUMAOPI 09/29/10
<br />PRODUCER
<br />L7R
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />(OC) Heffernan Insurance Brkrs
<br />LIMITS
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />1855 Katella Ave, Suite 255
<br />GENERAL LIABILITY
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Orange CA 92867 -4459
<br />EACH OCCURRENCE
<br />$1,000,000
<br />Phone:714- 997 -8100 Fax :714- 460 -9935
<br />X
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />INSURED
<br />09/23/11
<br />INSURERA: GREAT AMERICAN INSURANCE
<br />16691
<br />INSURERB: Great American Alliance
<br />MindyHuman Options
<br />INSURER C:
<br />$ 5,000
<br />Y,ieinheimer
<br />X Sexual Misconduct
<br />5540-A Trabuco Road
<br />INSURER D:
<br />S1,000,000
<br />Irvine CA 92620
<br />GENERAL AGGREGATE
<br />s2,000,000
<br />COVERAGES
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />L7R
<br />NSR
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />CY
<br />DATE MMlDD C
<br />DATE MMIDD
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$1,000,000
<br />A
<br />X
<br />X COMMERCIAL GENERAL LIABILITY
<br />PAC1669863
<br />09/23/10
<br />09/23/11
<br />PREMISES £ a oocurence
<br />$ 100,000
<br />CLAIMS MADE Fx_] OCCUR
<br />MED EXP (Any one person)
<br />$ 5,000
<br />X Sexual Misconduct
<br />PERSONAL& ADV INJURY
<br />S1,000,000
<br />GENERAL AGGREGATE
<br />s2,000,000
<br />GEN'LAGGREGATELI MIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$1,000,000
<br />POLICY D jEC LOC
<br />Emp Ben.
<br />1,000,000
<br />AUTOMOBILE
<br />LIABILITY
<br />A
<br />ANYAUTO
<br />PAC1669863
<br />09/23/10
<br />0„$/23/11
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$1000000
<br />ALL OWNED AUTOS
<br />Iq©
<br />-JJ�•
<br />BODILY INJURY
<br />$
<br />SCHEDULED AUTOS
<br />ps
<br />(Per person)
<br />X
<br />HIREDAUTOS
<br />_ i•
<br />X
<br />NON -OWNED AUTOS
<br />l(PerraLcdd
<br />nt)
<br />$
<br />� p
<br />PROPERTY DAMAGE
<br />$
<br />�►ty
<br />(Per accident)
<br />GARAGE LIABILITY
<br />PISS
<br />'
<br />AUTOONLY- EAACCIDENT
<br />$
<br />OTHERTHAN EA ACC
<br />$
<br />ANYAUTO
<br />$
<br />AUTO ONLY: AGG
<br />EXCESS /UMBRELLA LIABILITY
<br />EACHOCCURRENCE
<br />s4,000,000
<br />B
<br />X I OCCUR EI CLAIMSMADE
<br />PAC1669864
<br />09/23/10
<br />09/23/11
<br />AGGREGATE
<br />$4,000,000
<br />s
<br />DEDUCTIBLE
<br />$
<br />X RETENTION $10,000
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />_
<br />TORY LIMITS ER
<br />E.L. EACH ACCIDENT
<br />$
<br />ANY PROPRIETORIPARTNER/EXECUTIVI
<br />OFFICER/MEMBER EXCLUDED?
<br />If yes, describe under
<br />(fyes,dory beun
<br />E,L.DISEASE - EA EMPLOYE
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />$
<br />SPECIAL PROVISIONS below
<br />OTHER
<br />• Prof. Liability PAC1669863 09/23/10 09/23/11 Occurence $1,000,000
<br />• fEmployeeDishonesty IPAC1669863 1 09/23/10 1 09/23/11 Occurence $1,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />Project: Funding to provide counseling services in the City of Santa Ana,
<br />City of Santa Ana, its officers, employees, agents, volunteers and
<br />representatives are named as additional insured on General Liability policy
<br />per attached endorsement. Coverage is Primary & non - contributory. *10 Day
<br />Notice of Cancellation for non - payment /non - reporting.
<br />CERTIFICATE HOLDER rAM('9:1 I ATIn AI
<br />ACORD 25
<br />City of Santa Ana
<br />Attn: Frank Hernandez
<br />20 Civic Center Plaza
<br />(Santa Ana, CA 92701
<br />2009101)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />CIOFSAN DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />REPRESENTATIVES.
<br />ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />reserved.
<br />
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